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General NPI Number Information
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NPI Number | 1265548614
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Entity Type | Organization
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Legal Business Name | CAPITOL CITY FAMILY HEALTH CENTER INCORPORATED
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 3140 FLORIDA STREET
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City | BATON ROUGE
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State | LA
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Zip | 70806
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Country | US
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Telephone | 225-650-2000
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Fax | 225-650-2099
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Provider Business Mailing Address
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Address Line | PO BOX 66156
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City | BATON ROUGE
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State | LA
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Zip | 70896-6156
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Country | US
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Telephone | 225-650-2000
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Fax | 225-650-2099
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Authorized Official
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Title or Position | BILLING/CREDENTIALING MANAGER
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Name | MS. KENYA L NELSON
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Credential |
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Telephone | 225-650-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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